MR. Ahmad Keenan Taj Logan

NPI #1073238069 in Mckinleyville, California

Provider Information

NPI Number: 1073238069
Entity Type: Individual
Name: MR. Ahmad Keenan Taj Logan
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Oct 11, 2022
Last Updated: Oct 11, 2022

Practice Location

Address: 1622 BARTOW RD
City: Mckinleyville
State: California
ZIP Code: 95519-4309
Phone: (925) 497-6601

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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